Deciding which type of weight-loss surgery is right for you depends on many factors, including your prior efforts to lose weight.

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Once you make the decision to have weight-loss surgery (WLS), also known as bariatric surgery, you and your medical team will also need to decide which type of surgery for weight loss will be best for you.

Surgery for Weight Loss: Types of Bariatric Surgery

It is best to choose a surgeon affiliated with a program that offers multiple types of bariatric surgery, says bariatric surgeon Robin Blackstone, MD, director of the Scottsdale Bariatric Center, and medical director of the Scottsdale Healthcare Bariatric Program in Arizona.

"That way [bariatric surgery patients] are not slotted into one procedure because that is all the program does," says Dr. Blackstone.

Your options for weight-loss surgeries may include:

Adjustable gastric band. "The adjustable gastric band (Lap-Band) is a medical device that is placed around the outside of the stomach that causes a partition of the stomach, but the stomach is not divided," says Blackstone. With an adjustable gastric band, food flows throughout your digestive system in the same way it did before, but the band limits your food intake.

Roux-en-Y gastric bypass. For a gastric bypass, the stomach is separated into two parts. "One part is really small, and that is the part that still receives food," says Blackstone. "The other part is left in the abdomen, but it doesn't receive food any longer." In addition, a gastric bypass involves linking a portion of the small intestine directly into the "new stomach." Gastric bypass procedures drastically reduce the amount of food that you can eat, for two reasons: Your usable stomach is much smaller than before, and your food is shuttled directly into the small intestine, which triggers hormones that tell your body that you are full.

Biliopancreatic diversion with a duodenal switch. Although it is rarely performed (accounting for less than 5 percent of all weight-loss surgeries), the duodenal switch procedure can produce dramatic weight loss. For a duodenal switch, your surgeon will remove a large portion of your stomach and connect your new, smaller stomach directly to the lower part of your small intestine. This results in decreased absorption of food and nutrients.

Vertical-sleeve gastrectomy. A vertical-sleeve gastrectomy removes a large portion of your stomach. "That procedure was actually performed as the first part of the duodenal switch — in very large patients in preparation to come back and do the switch," says Blackstone. When doctors found out the patients were having success with just the vertical-sleeve gastrectomy, it was approved as a primary bariatric surgery procedure.

Surgery for Weight Loss: Deciding Which Procedure Is Best for You

According to Blackstone, bariatric surgeons consider the following when counseling patients on their WLS options:

History of weight loss. Your doctor will ask you about previous attempts at weight loss, which can help determine what type of bariatric surgery is best. For instance, the adjustable gastric band can be successful in very committed patients, but other patients may become frustrated with its less dramatic weight loss.

Support system. Undergoing a more invasive procedure may mean a longer recovery. That's why your doctor will want to know how much support you will have at home after you have had bariatric surgery, and whether you will be able to take time off from work.

Medical history. If you have obesity-related diseases, such as type 2 diabetes, high blood pressure, cholesterol problems, or sleep apnea, a bariatric surgery that produces faster, more dramatic results may be your choice. "These patients are probably not people who have a lot of time to experiment with less invasive procedures; they need to go to something that is going to work for them for sure," says Blackstone.

Current weight and weight loss goals. Blackstone says that the vertical-sleeve gastrectomy and the adjustable gastric band procedures generally work best in patients with a BMI (body mass index, or weight in relation to height) of 35 or less, while the gastric bypass and duodenal switch tend to work best in larger patients.

Risk tolerance. While all bariatric surgery procedures are now considered very safe, the death and complication rates vary between procedures. In general, the adjustable gastric band has the lowest death rate, and the duodenal switch has the highest. Your doctor will talk with you about your individual risks and benefits of each procedure.

Once your medical team has assessed your individual situation, they can match you with bariatric surgery procedures that are options for you.

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